DESCRIPTION (investigator's abstract): It has long been observed that disabled children are at risk for maltreatment. In this proposal, it is suggested that children who are physically or medically challenged--depending upon their parenting history--may show elevated "promise" as well as "problems." The possibility of positive (as well as negative) responses to adversity reflects an emerging paradigmatic shift within the social and health sciences away from sickness/helplessness/risk to health/optimism/resilience. In the proposed research, we are concerned with the specific mechanisms (including both cognitive and neurohormonal processes) that foster positive versus negative outcomes for "challenged" children. We will study child characteristics (e.g., the apparent unresponsiveness of a hearing impaired child; the apparent dependence of a visually impaired child) and parents' attributional biases that lead them to focus either on problems or promise associated with their physically or medically challenged children. We will assess the future outcomes of "challenged" infants as a function of their early experiences, and the current outcomes of "challenged" young adults as a function of their past experiences. Hypotheses are tested with respect to the interactive effects of parents' attributions/expectations and offspring characteristics on (1) parental practices (creation of efficacy-promoting experiences vs. abuse/neglect), (2) children's neurohormonal adaptation to stress (habituation vs. sensitization), and (3) children's social/emotional and cognitive/creative outcomes. Children's hormonal patterns and parental practices will be explored as mediators of later outcomes. Finally, we will study the benefits of an attribution-based home visitation program for new parents of "challenged" children as a means of reducing risk and fostering opportunity.